How to talk to people with dementia: 15 tips for communicating with them.

Several guidelines for communicating in the best possible way with patients with dementia.

The collection of diseases and disorders known as dementias is one of the greatest challenges one of the greatest challenges facing medicine today.. With an increasingly aging population, the prevalence of this type of disorders is increasing with the passage of time, with more and more cases coming to consultation.

Psychologists and neuropsychologists, as well as any other type of professional within the field of health or even at a social-care level, must therefore be properly prepared to deal with this type of patients, taking into account the possible difficulties that may arise.

Among them we can find a basic aspect that can make interaction very difficult, both to assess their capabilities and to perform various therapies to help maintain and enhance their skills as much as possible: communication. That is why in this article we are going to mention a series of small aspects to take into account when talking to patients with advanced dementia..

Briefly recalling the concept of dementia

We understand dementia as a type of disorder characterized by the presence of the loss or deterioration of one or more mental faculties whose alteration generates difficulties in daily life or a decrease in the subject's quality of life (causing a previously non-existent limitation). It is usually a deterioration that progressively a deterioration that progresses progressively and irreversibly.There are some that are treatable or in some cases there is even a complete recovery (such as those generated by infections).

This deterioration is usually due to organic causes, although in some cases the exact reason for its appearance is unknown (although neurochemical and structural alterations that generate or participate in the symptomatology are known, not because they occur). The evolution can be very variable in each case, although the tendency is towards a progressive or gradual deterioration in most cases.

How to talk to a person with dementia

There are a number of different dementias, which can affect different abilities. In many cases, there ends up being an impairment in the ability to attend, remember, retain or even understand. and process what is said to them can make it complex to treat and even evaluate them. That is why we offer below a series of indications that may be useful when treating a patient with these characteristics.

Speak clearly and vocally

A major aspect of communicating with a dementia patient is to be willing to adjust to the needs of the patient. be willing to adjust to the person's needs.. Our tone must be adjusted to what the person needs and it must be possible to understand what we are expressing. Vocalization is essential.

2. Short sentences, slow pace

Using excessively complex structures will make it difficult for the patient to understand. It is necessary to use a vocabulary adjusted to the patient's capacity (and to his knowledge and level of studies) and the shorter and clearer sentences the better. Avoid ambiguities and use a slower pace..

3. Repeat things

Whether there are problems encoding new information, retaining it or simply paying attention, it can be difficult for a person with more or less advanced dementia to grasp what is being asked of him or her from the start. Repeating instructions may be more than necessary depending on the case.

4. Make sure they understand what you are saying.

Linked to the above, it is essential to make sure that the patient has understood what is being asked of him/her. This should be done in such a way that the patient does not feel ridiculed or bad for requiring further explanations..

It should be borne in mind that many people, even if they maintain sufficient skills, pretend to have understood what they are being told out of embarrassment or social desirability, and this is something that is actually hindering efficient communication.

5. Tolerate frustration and don't get upset.

The fact that a person does not understand what we want to say, does not achieve an improvement or that there is no efficient communication between patient and therapist can be frustrating. Dealing with this type of patient may require a certain amount of patience, as well as taking into account that the patient is not doing it on purpose.

6. No reproaches

It may seem obvious, but often the environment or even some professionals (especially those not specialized in this area) tend to reproach in one way or another the forgetfulness or loss of faculties. The person does not forget things for the sake of it or because he does not value what he is told: he is being affected by a disorder that he cannot control and that he cannot control. a disorder that he cannot control and that causes him not to be able to store the information..

Also, especially in the early periods of dementia, patients are often aware of the presence of deficits. Reproaching them will only increase their discomfort and distress at the deterioration they have already perceived.

7. Avoid distractors

It can be difficult for a person with dementia to maintain concentration. It is therefore advisable that attempts at communication take place in a context where there are as few distractions as possible. A crowded office or a radio on, for example, can cause the person to lose the can easily cause you to lose the thread..

8. Find ways to communicate

It is not uncommon to have serious problems communicating orally. Also, in advanced stages, people with dementia may become mute, unable to follow a conversation because they lose concentration or even remain in a state of absence. It is important to try to find a way to communicate, as socialization is important and can be reassuring.

If oral language does not work, gestures and mimicry, or pictures or drawings representing various concepts may be used.. Relevant songs can also be used. If they lose concentration, a caress or a little squeeze on the hand can help them follow the thread of the situation a little more.

9. Initiate interaction

While it may be interesting to let the patient take the first step in communicating, it can be difficult for them. Many dementias end up affecting the patient's ability to motivate action and interaction, so it is generally more efficient to let the professional try to establish the first step of communication. that the professional is the one who tries to establish the interaction and direct it..

10. Better concrete indications or choices than general proposals

This is a small mistake that some people make and that can alter the performance and performance of the person in the task that is being asked or the question that is being asked. Making general proposals means first of all that you have to imagine and generate answers, as well as having to process the idea of whether you should do it or not. This implies a much greater effort, as well as a greater likelihood of confusion. greater likelihood of confusion.

If we want him to carry out an action, it is important to tell him what he is expected to do, in a concrete way. It is not the same to tell someone to raise a hand as to ask him if he could raise it. In the first case he can do it, while in the second case it can be interpreted as a mere question to be answered. Also, perhaps decision making is one of the impaired skills. It may be useful to assess this, but you need to consider what you are seeing at any given time.a hand.capabilities tell him to do something.

11. Try to use positive phrases

It is good to to use instructions and phrases that express what the patient does or should do. in the positive, avoiding the use of negations that are more complex to understand.

12. Give it time

Sometimes, something that is interpreted as a lack of memory or reasoning ability may actually be a problem of processing speed. By this we mean that we should not rush and jump from one thing to another, but that we have to give the patient a reasonable amount of time to process the information and/or to express himself/herself..

13. The position, an important element

Another aspect to take into account when talking to a patient with dementia is the place or space we occupy. We should position ourselves in front of the person, facing him/her and relatively close to him/her, so that our person can understand what we are saying.In such a way that our person captures their attention and has an easier time observing our gestural language and listening to our voice.

14. Do not run to identify everything as a symptom of dementia.

We must bear in mind that it is not uncommon for people with dementia or simply elderly people to have hearing problems, something that must be assessed when examining a patient. in order not to confuse a sensory problem with symptoms of dementia.. It is also necessary to previously assess whether or not the patient has been schooled, which is also relevant in terms of adjusting tests and treatments to their needs.

15. Always keep in mind and treat him/her as an adult and dignified person.

A person with dementia is still an adult. The treatment of a person with dementia should always respect their dignity and treat them with respect..

Even if the person is not aware of where they are or with whom, they should be treated as adults and not infantilized. Likewise, they should not be spoken of as if they were not present, even if they show no reaction to stimulation or language.